Urinary tract infection (UTI) is one of the most common bacterial infection in children affecting 1.7% of boys and 8.4% of girls before the age of 7 years. The diagnostic work up can be demanding, especially in infants where the symptoms are often vague and urine sampling for urinalysis and the mandatory urine culture is more challenging. Antibiotic treatment for 7–10 days is recommended in febrile UTI and 3–5 days in cystitis. It can safely be given orally to most children. Vesicoureteral reflux (VUR) is often diagnosed after a UTI, but nowadays prenatal hydronephrosis is an increasing reason for detecting VUR, with growing awareness of the congenital nature of many of the kidney damages associated to VUR. New kidney scarring and deterioration of old preexisting damage is strongly associated to high grade VUR and recurrent febrile UTI. However, long-term consequences of kidney damage related to UTI and VUR, are rare and in most cases limited. The objective of different guidelines for UTI in children is to identify children with high grade VUR and severe kidney damage. They also have a common aim to eliminate the discomfort of recurrent symptomatic UTI and reduce the risk for long-term complications.